NURSE CARE COORDINATOR - ELDERLY
About The Position
The Nurse Care Coordinator - Elderly provides care coordination services for elderly or disabled members who need assistance to safely live in the least restrictive setting. The work requires conducting site visits in the members' home environment, developing care/service plans, regular monitoring, and periodic follow-up visits. The work requires the flexible use of a wide range of highly skilled psychosocial evaluation and intervention techniques to provide support and stabilization for members. The Nurse Care Coordinator - Elderly is required to make referrals for community resources, and behavioral health services in order to assist members in maintaining health, safety, and independence through knowledge of social work principles, practices, and their application to complex care coordination.
Requirements
- Must be licensed as a Registered Professional Nurse in the State of Illinois, required.
- A minimum of two (2) years of experience providing services and support to elderly or disabled living in a community based setting.
- A minimum of one (1) year of care coordination experience is required.
- Must be able to travel to work sites throughout Cook County, required.
Nice To Haves
- Fluent in Spanish or Polish
Responsibilities
- Visits members in the home to complete an assessment, develop a care/service plan that meets member needs and provide periodic follow-up; reviews risk scores, previous service/care plans, and/or medical records
- Verifies eligibility for waiver services
- Documents findings in the Care Management System
- Meets or exceeds timelines associated with case activities
- Provides succinct presentation of member, and solidifies plan of care with Interdisciplinary Care Team (ICT)
- Completes a member assessment according to department policy and procedure
- Develops and implements a member centered care plan that recognizes the patient's risk level, priorities, member preferences and medical needs based upon screening and assessment results
- Creates a service plan that reflects the needs identified during Determination of Need (DON) screening and is consistent with Determination of Aging (DOA) policy
- Communicates effectively with Medical Home Team members and care providers to support coordinated integrated care
- Evaluates progress made towards agreed upon goals
- Schedules visits with member upon member request, a change in condition, new information or, as mandated by the waiver
- Provides information to support all service authorizations
- Refers patients to community based resources in order to maintain levels of wellness in the members community environment
- Initiates reporting and conducts necessary follow-up on mandated reporting (prevention and notification of abuse, neglect, and exploitation); documents findings in the Care Management System
- Utilizes evidence based practices for working with elderly and persons with disabilities
- Participates in job specific (20 hours annually), CCHHS and departmental mandatory training
- Travels throughout the Cook County area
Benefits
- Medical, Dental, and Vision Coverage
- Basic Term Life Insurance
- Pension Plan and Deferred Compensation Program
- Employee Assistance Program
- Paid Holidays, Vacation, and Sick Time
- 100% Tuition Reimbursement for nursing-related programs (for NNOC members)
- You may also qualify for the Public Service Loan Forgiveness Program (PSLF)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Executive, Legislative, and Other General Government Support
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
